Exercise Can Substitute Effectively as Second 'medication' for People with Depression

DALLAS – Aug. 24, 2011 – Exercise can be as
effective as a second medication for as many as half of depressed
patients whose condition have not been cured by a single
antidepressant medication.

UT Southwestern Medical Center scientists involved in the
investigation, recently published in the Journal of Clinical
Psychiatry, found that both moderate and intense levels of daily
exercise can work as well as administering a second antidepressant
drug, which is often used when initial medications don't move
patients to remission. The type of exercise needed, however,
depends on the characteristics of patients, including their
gender.

These findings are the result of a four-year study conducted by
UT Southwestern's psychiatry department in conjunction with the
Cooper Institute in Dallas. The National Institute of Mental
Health-funded study, begun in 2003, is one of the first controlled
investigations in the U.S. to suggest that adding a regular
exercise routine, combined with targeted medications, actually can
relieve fully the symptoms of major depressive disorder.

"Many people who start on an antidepressant medication feel
better after they begin treatment, but they still don't feel
completely well or as good as they did before they became
depressed," said Dr. Madhukar Trivedi, professor of psychiatry and
the study's lead author. "This study shows that exercise can be as
effective as adding another medication. Many people would rather
use exercise than add another drug, particularly as exercise has a
proven positive effect on a person's overall health and
well-being."

Study participants diagnosed with depression, who ranged in age
from 18 to 70 and who had not remitted with treatment using a
selective serotonin reuptake inhibitor antidepressant medication,
were divided into two groups. Each group received a different level
of exercise intensity for 12 weeks. Sessions were supervised by
trained staff at the Cooper Institute and augmented by home-based
sessions.

Participants – whose average depression length was seven
years – exercised on treadmills, cycle ergometers or both,
kept an online diary of frequency and length of sessions, and wore
a heart-rate monitor while exercising at home. They also met with a
psychiatrist during the study.

By the end of the investigation, almost 30 percent of patients
in both groups achieved full remission from their depression, and
another 20 percent significant displayed improvement, based on
standardized psychiatric measurements. Moderate exercise was more
effective for women with a family history of mental illness,
whereas intense exercise was more effective with women whose
families did not have a history of the disease. For men, the higher
rate of exercise was more effective regardless of other
characteristics.

"This is an important result in that we found that the type of
exercise that is needed depends on specific characteristics of the
patient, illustrating that treatments may need to be tailored to
the individual," said Dr. Trivedi, director of the Mood Disorders
Research Program and Clinic at UT Southwestern. "It also points to
a new direction in trying to determine factors that tell us which
treatment may be the most effective."

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Other researchers from UT Southwestern involved in the study
were Dr. Tracy Greer, assistant professor of psychiatry; Dr. Thomas
Carmody, assistant professor of clinical sciences and psychiatry;
Dr. Prabha Sunderajan, clinical assistant professor of psychiatry;
and Bruce Grannemann, faculty associate in psychiatry. Scientists
from Louisiana State University, South Carolina State University,
the American Psychological Association, Martindale Research Corp.
and Klein Buendel Inc. also contributed.

In addition to NIMH funding, the study was supported by grants
and awards from the National Alliance for Research on Schizophrenia
and Depression, and the National Cancer Institute.

Visit http://www.utsouthwestern.org/neurosciences to learn more
about UT Southwestern's clinical services in neurosciences,
including psychiatry.

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www.utsouthwestern.edu/home/news/index.html